BPH since I was 36 years old

Hi Kevin, and welcome back to the world of caring about your sex life!  :-D  

Others will advise on meds, I'm sure.  I tried what you tried,  drugs-wise, had same results, and since I was in my own new, post-divorce relationship, did NOT like the effects I was experiencing, which were also like yours.  

I would suggest consider the surgical alternatives (Uro-lift, Holep, even green light), learn all you can.  Guys here will surely offer some thoughts.  For most of us, TURP is to be avoided at all costs, and liekly the first words to come out of any urologist you talk to.  READ ABOUT ALTERNATIVES, PLEASE!

Meanwhile, please consider this idea:  learn to self-catheterize  (NOT wearing a bag!), just before retiring at night.  It takes a little getting used to, but to get a full night's sleep, every night, What's it worth to you???  SpeediCath or Magic3 are the hands-down favorites on the forum.  

Sorry to hear the trouble your having. I am 63 and I too have been on Tamsulisin for 4 years now and Finasteride and like you sex drive is non existent with little or no ejaculation. Mainly retrograde . You ask about herbal remedies.... My uncle swears by raw pumpkin seeds and says he has definitely seen an improvement and night time visits to the bathroom dramatically reduced. I now only have de- caff coffee and tea and take pumpkin oil capsules but it's too early to tell yet if any improvement in the condition. A recent study in China says that taking vitamin d supplements has proved successful in many cases so I take them also. Wishing you well with whatever you try!

Try Cialis - you can get a free sample I think as a trial. Canada just started making it as I believe so it's probably more affordable than in the USA.

Kevin....I’ve been following this blog for about 7 months and have heard a lot about cathing, drugs, and the various BPH procedures.  All useful info. Bottom line:  drugs may work for a while (for me it was about 2 years), but they can also result in damage the bladder from constantly being over extended/full .  The real answer imho is surgery, specifically HoLEP.  I did the research on all the procedures (except PAE….had not heard of it), and chose HoLEP.  It is the best surgical procedure because; 1) less time in the hospital and a on catheter (less than 24 hours), 2) less bleeding, 3) very small chance of needing a repeat procedure, and 4) they remove prostate tissue (instead of burning it), so they can biopsy it for cancer.  You do need to find an experienced doc to do this.  Yes, you the have retro ejac, but sex drive returns, and unless you want to have more children, it’s not a problem.  I’ve heard too many horror stories on this blog about TURP & GL.  I was retaining close to 800ml, and my prostate was 85 grams, PSA 3.8.  After it was 46 grams, PSA 0.2.  I had my surgery in January, and now have no problems at all.

If I had it to do over, I think I’d try PAE as it is relatively non-invasive and there have been some good results reported in this blog (as well as some not so good).   Also be aware that the bladder can be damaged by doing nothing. Some folks have had success with other procedures such as urolift, but just as many not.

Lastly, the experience & ability of the doc is critical, and often difficult to determine.  Hospital ratings for various specialties can be found in the US News & World Report evaluations.  Bios for docs may or may not be available.  For example, the Mayo Clinic was rated best in the nation, and they have the education and publications of their docs listed…… very helpful. Best of luck!